Search

Nearly 80 new cases of pediatric cancer are diagnosed in Lithuania each year. Since 2005, we have been conducting a study evaluating the quality of life of children suffering from cancer in Lithuania. The participants were children between the ages of 2 and 18 years, diagnosed with oncologic diseases during the period from March 2005 to March 2006, and their parents. The PedsQLTM (Pediatric Quality of Life InventoryTM) was used. This questionnaire is specifically designed for investigating the quality of life in children between the ages of 2 and 18 years. The PedsQL questionnaire is designed according to the level of cognitive activity of children and applied to children of four age groups: 2–4, 5–7, 8–12, and 13–18 years of age. The questionnaires were completed by children between the ages of 8 and 18 years in addition to parents of children from all age groups. The families of 63 children suffering from cancer participated in the study. A total of 44 children and teenagers between the ages of 5 and 18 years and 53 parents (mother, father, close relative) filled out the questionnaire. Data from the study showed that children suffering from cancer (irrespective of their age) in addition to their parents evaluated their physical health as being worse than their psychosocial health. The parents had the opinion that children from all age groups experienced negative emotions: the younger children were afraid of giving blood for tests, whereas the older children were worried about the future. In the oldest age group of participants (13–18 years), children felt disease-related fatigue more often than their younger counterparts.

The aim of the article is to present a case of incidental renal cell carcinoma in living donor kidney, which was successfully transplanted following resection of carcinoma. A 38-year-old female recipient with end-stage renal disease was on maintenance hemodialysis for 4 months. The donor was her mother aged 60 years. Preoperative renal scintigraphy, aortography, and ultrasound examination confirmed good function of donor kidneys. The reason for transplanting the right kidney was slightly diminished phase of secretion revealed by scintigraphy. On February 14, 2001, mother’s right kidney was removed, and after hypothermic perfusion, yellowish nodule in the upper part of the kidney was found. Microscopic investigation of the resected material revealed renal clear cell carcinoma. Decision on complete tumor resection was based on the findings of microscopic examination. After suturing the resected segment, mother’s kidney was transplanted successfully. The postoperative course was normal in the donor and the recipient as well. Cyclosporine A was replaced with Rapamune. No tumor recurrence was seen for more than 6 years after transplantation, and transplant function was normal.

The aim of this article was to review the available literature regarding to the use of strontium-89 in the palliation of osteoblastic bone pain. The data of many researches showed that approximately 80% of patients witch pain from osteoblastic lesions resulting from prostate or breast cancer experience significant pain relief by administration of strontium-89, witch only mild levels of hematotoxicity. The duration of pain relief in some cases exceeded 3-6 months. Indications for administration of strontium-89, effectiveness and duration of the treatment, side effects are reviewed in this article.

Radikali cistektomija šiuo metu laikoma invazinio šlapimo pūslės vėžio gydymo standartu Europos Sąjungoje ir Jungtinėse Amerikos Valstijose. Pastaraisiais dešimtmečiais dedamos pastangos sukurti tokias gydymo metodikas, kurios leistų išvengti negalią sąlygojančios operacijos šios grupės pacientams. Daugelis klinikinių tyrimų parodė, kad skyrus kompleksinį gydymą, kurį sudaro transuretrinė šlapimo pūslės rezekcija, sisteminė chemoterapija ir spindulinis gydymas, galima išsaugoti funkcionuojančią šlapimo pūslę ir užtikrinti tokius pat išgyvenimo rodiklius kaip ir po cistektomijos. Naujausių klinikinių tyrimų analizė rodo, kad įtraukus į chemospindulinio gydymo protokolus naujus chemopreparatus, gemcitabiną ir taksanus, žymiai pagerėja vietiškai išplitusio šlapimo pūslės vėžio konservatyvaus gydymo efektyvumas. Tarp prognozinių parametrų, kuriais remiantis galima atrinkti ligonius organą išsaugančiam gydymui, yra mažesnė naviko stadija, makroskopiškai radikaliai atlikta šlapimo pūslės rezekcija ir nėra hidronefrozės. Radical cystectomy is the standard of treatment for muscle-invasive transitional cell carcinoma of the bladder in European Union and in United States. During the last few decades, several clinical trials were performed with the aim to evaluate new treatment methods as an alternative to radical cystectomy for selected patient groups. According to some clinical trials, it is clear that bladder preservation is possible without comp¬romising overall survival of these patients. Organ preservation requires a combined-modality treatment including transurethral resection of bladder tumor, radiation therapy, and systemic chemotherapy. Incorporation of chemotherapeutic agents such as gemcitabine or taxanes in bladder-sparing protocols improves the results of conservative treatment of locally advanced bladder cancer. Pretreatment selection criteria and the most important prognostic factors are macroscopically complete transurethral resection of bladder tumor, absence of hydronephrosis, and lower T stage.

Darbo tikslas. Įvertinti pusantrų metų patirtį Lietuvoje, gydant tiesiosios žarnos navikus transanaline endoskopine mikrochirurgija Vilniaus universiteto ligoninės „Santariškių klinikos“ Pilvo chirurgijos centre. Tyrimo medžiaga ir metodai. Operacijoms buvo atrenkami ligoniai, sergantys tiesiosios žarnos adenomomis ir mažos rizikos piktybiniais navikais: T1 stadijos, geros ir vidutinės diferenciacijos, be invazijos į limfagysles ir kraujagysles. Naviko stadija iki operacijos nustatyta, atlikus transanalinę endosonoskopiją ir rektoskopiją su dauginėmis makrobiopsijomis. Rezultatai. Operuoti 47 ligoniai. Navikų dydžio vidurkis 3,4±1,4 cm (svyravo nuo 1 iki 7 cm). Iš viso pašalinti 25 (52, 1 proc.) piktybiniai navikai ir 23 (47,9 proc.) adenomos. Ikioperacinės ir galutinės klinikinės diagnozės nesutapo 14 (29,8 proc.) ligonių. Padarytos 43 (89,6 proc.) radikalios operacijos (R0), 5 (10,6 proc.) – abejotino radikalumo (RX). Konstatuota 1 (2,1 proc.) intraoperacinė ir 1 (2,1 proc.) pooperacinė komplikacija. Trims ligoniams po CaT2 pašalinimo taikyta adjuvantinė radioterapija. Stebėti 26 ligoniai praėjus 3–17 mėn. po operacijų: 17 po piktybinių navikų, 9 – po adenomos pašalinimo. Nustatytas 1 (2,1 proc.) tubuloviliozinės adenomos recidyvas. Kitų komplikacijų nekonstatuota. Išvados. Ankstyvieji transanalinės endoskopinės mikrochirurgijos rezultatai, gydant tiesiosios žarnos adenomas ir mažos rizikos T1 vėžį, yra geri. Mažas komplikacijų ir navikų recidyvo pro¬centas šioje grupėje... [toliau žr. visą tekstą] Objective. The aim of this study was to assess one and a half years experience gained in Lithuania while treating rectal tumors with transanal endoscopic microsurgery in the Centre of Abdominal Surgery of Vilnius University Hospital “Santariškių klinikos“. Materials and methods. The patients who had rectal adenomas and low-risk T1 carcinomas of good or moderate differentiation, with no lymphatic and vascular invasion were selected for surgery. Tumor stage was determined by transanal endosonoscopy and rectoscopy with multiple macrobiopsies before surgery. Results. A total of 47 patients were operated on. The average tumor size was 3.4±1.4 cm (ranged from 1 to 7 cm). Overall 25 (52.1%) carcinomas and 23 (47.9%) adenomas were removed. Pre-operative diagnoses did not correspond to the final clinical diagnoses in 14 (29.8%) cases. Forty-three (89.6%) radical operations (R0) and 5 (10.6%) doubtful complete operations (RX) were performed. One (2.1%) intra-operative complication and one (2.1%) post-operative complication were observed. After the removal of Ca T2 three patients underwent adjuvant radiotherapy. Twenty-six patients were followed up for 3–17 months after operation: 17 after removal of cancer and 9 after removal of adenoma. One (2.1%) recurrence of a tubulovillous adenoma was diagnosed. No other complications were reported. Conclusions. Initial results of transanal endoscopic microsurgery obtained while treating rectal adenomas and low-risk T1 cancers are promising. The... [to full text]

Gimdos kaklelio vėžys Lietuvoje palyginus dažnas (sergamumo struktūroje tarp moterų piktybinių navikų šis vėžys yra ketvirtoje vietoje). Lietuvoje yra duomenų, kad nuo 1992 m. gerokai auga gimdos kaklelio vėžio atvejų skaičius. Svarbus gimdos kaklelio vėžio rizikos veiksnys – žmogaus papilomos viruso (ŽPV) infekcija. Šio tyrimo tikslas. Palyginti moterų, sergančių gimdos kaklelio vėžiu, taip pat moterų, kurioms nustatytas gimdos kaklelio intraepitelio pažeidimas, ir sveikų moterų infekuotumą ŽPV, nustatyti ŽPV tipus bei 16 ŽPV tipo variantus, siejamus su gimdos kaklelio vėžiu. Mėginių, paimtų iš gimdos kaklelio, tyrimams naudoti polimerazės grandininės reakcijos ir DNR sekos nustatymo metodai. Moterų, sergančių gimdos kaklelio vėžiu, infekuotumas ŽPV – 92,7 proc., moterų be vėžinės patologijos – 26,7 proc. (p